Medication Therapy Management (MTM) Program

We offer a program to help our members with their medicines. It is called the Medication Therapy Management Program, or MTM Program. Some members who take several medications for different medical conditions may qualify for this free program.

What’s the purpose of the MTM Program?

The MTM Program helps make sure that you understand how to take your medications correctly, and addresses medication-related problems such as side effects, use of higher risk medications and interactions between medications. We can do this by talking to you about your medications over the phone and by periodically reviewing your pharmacy claims throughout the year. We’ll communicate with you and your doctor if we find any medication-related problems that we feel should be addressed.

Do you qualify for the MTM Program?

To qualify for the MTM Program, you must meet all three of the following criteria:
  • You’ve been diagnosed by your doctors with at least three of the following medical conditions: diabetes, high blood pressure, high cholesterol, chronic heart failure, osteoporosis, asthma, COPD or depression.
  • You have filled prescriptions for at least eight covered Part D medications in the current calendar year.
  • You and others on your behalf (including BayCarePlus) have paid at least $1,011 for your medications in the previous three months.
If you’re eligible for the MTM Program, we’ll automatically enroll you in the program and send you a welcome packet in the mail.

What’s a Comprehensive Medication Review, and how can you request one?

We offer all our members in the MTM Program an opportunity to review their medications with a BayCarePlus pharmacist or other trained health care provider over the phone. We call this a Comprehensive Medication Review. If you’d like to have a call, you can contact us and request a Comprehensive Medication Review. Please have a list of your medications or your medication bottles with you at the time of your call. This includes prescription medications, over-the-counter medications and supplements you’re taking. During the phone call we’ll review your medications in detail. We can talk about how to best take your medications, your costs and any other problems you’re having with your medications. We can also help you set health goals and make plans to accomplish those goals. We’re happy to address any questions or concerns you have about your medications. Most calls take about 20 to 30 minutes. After the call we’ll send you a written summary of the discussion. The summary has a medication action plan that recommends what you can do to make the best use of your medications, with space for you to take notes or write down any follow-up questions. You’ll also get a personal medication list that will include all the medications you’re taking and why you take them. If you’d like a copy of a blank personal medication list, please click here.

How can you get more information about the MTM Program?

If you’d like more information about the MTM Program, please contact BayCarePlus Customer Service. If you misplace any letters that we’ve sent you, please contact Customer Service and request that we send another letter. Again, there’s no cost for you to participate in the BayCarePlus MTM Program.

What if you’re enrolled in the MTM Program, but don’t want to participate in the program?

If you receive a MTM Program welcome packet from us but don’t want to participate in the MTM Program, you can let us know by contacting us. If you previously told us that you didn’t want to participate in the MTM Program, but have changed your mind and now wish to participate, please contact us. This program is not considered a benefit – it is a free program for those who qualify.